Health insurers have lots of sneaky ways to deny insurance claims because, of course, the less they pay, the more money they get to keep. I got some good advice from professional patient advocate, speaker and radio-show host Trisha Torrey on what we consumers can do to help get coverage when the insurers are trying to wiggle out of their obligations…

Six Secrets to Get Your Health Insurance Company to Pay

1. Be persistent. Health insurance representatives generally will speak as if their decisions come from policies that allow for no variation. What the companies don’t want you to know is that sometimes when you get turned down by one representative, another may be more willing to give you the answer you want to hear.

Try this: If a claim is denied, it’s worth checking to see whether you get consistent answers from two different sources — perhaps call again to see if another representative makes the same decision and/or speak to someone with more authority.

2. Get everything in writing to even out the playing field. Insurance companies are scrupulous about keeping copies of all medical paperwork and correspondence involving your care — including letters and e-mail correspondence. They also may record telephone conversations and, if there is a dispute about who said what and when, you’ll do far better if you’ve also kept careful records.

To play at the same level: Retain copies of all correspondence (paper and online) that you send and receive. Also keep a log of notes and details of all phone calls (date and time, the name of the person you spoke to, what you discussed, any verbal commitments, etc.). And never accept only a verbal commitment from an insurance company — always ask for confirmation in writing.

3. If you had no choice, you had no choice. If you weren’t able to choose who your provider was, you should not have to pay higher, out-of-network costs.

For example: When your in-network surgeon chooses to use an out-of-network anesthesiologist for your surgery… or sends you to an out-of-network lab for blood work… the choice of provider was out of your control.

What to do: Insurers may do their best to deny the top level of reimbursement, but Torrey says to be persistent in stating your case and insisting on coverage. Similarly, when emergency care is needed and you are therefore not in control of health-care decisions, you may not be liable for higher out-of-network costs. Check your policy. Also, in some states, out-of-network emergency care coverage is mandated by law.

4. Tell all… there’s no such thing as too much information. Requirements are tightening up for screening tests that look for signs of disease before symptoms develop, and some insurers limit the diagnostic tests they’ll cover, too. Check your policy to be sure.

To get around this: Be sure you clearly and specifically report the symptoms you are concerned about, even if they’re embarrassing (for instance, for colonoscopy a change in bowel movements or traces of blood in your stool).

5. Even an insurance company can be intimidated by credentials and titles. Irate consumers aren’t very scary to big insurance companies… but doctors and congressional representatives can make them nervous. If coverage is initially denied to you for a test or other service, an explanatory call from your physician might get a different outcome.

A good strategy: On critical correspondence, copy your congressperson, state insurance commissioner or another state board that regulates health plans. You can find links to the regulatory entities in all 50 states at the Web site of the National Association of Insurance Commissioners & the Center for Insurance Policy and Research (www.naic.org — check “States & Jurisdiction Map”). That way, the insurer will have to answer to them for the decisions it makes.

6. Patient advocates know what works… and insurers know it. Insurers are not fans of these persistent, well-informed third parties who can help slice through red tape and are good at negotiating favorable coverage and settlements.

How to find one: Start with a service you don’t even have to pay for — the nonprofit Patient Advocate Foundation (www.patientadvocate.org or 800-532-5274), which provides free case-management services for people with serious diseases, such as cancer, and has lots of experience needling insurance companies. (Note: This organization is staffed by volunteers, so its phones often are busy. If you find that is the case, you can go directly to its “Request Patient Assistance with a Case Manager” form by clicking http://gallery.patientadvocate.org/requests/paf_cm_request.php.)

There are also for-profit patient advocate firms that employ nurses and other health-care professionals to argue cases on patients’ behalf. They may charge as much as $150 to $200/hour — but for a big bill, it might be worth it. You can find patient advocates in your region at Torrey’s Web site, AdvoConnection.com, a directory of patient advocates.

As Torrey notes, insurers are a wily lot — but you can get real results by using these secrets to turn the tables on them and get the health coverage you need and deserve.

Source(s):

Trisha Torrey, patient advocate, syndicated newspaper columnist, radio talk-show host and national speaker based in upstate New York. She is author of You Bet Your Life! The 10 Mistakes Every Patient Makes (available February 2010). Visit her blog at EveryPatientsAdvocate.com/blog.

I read once you should, “every day do something that scares you.” Now I don’t want you to look for your parachute but a little fear goes a long way to opening and conditioning your senses to increase your intake of information. The military said, “Fear is your friend…” and I believe this is what they meant. They also said, “courage isn’t the absence of fear, but the mastery of it.”

Fear can help you master anything else. A little anxiety causes us to be vigilant for errors, focus our energy and seek ways to improve performance in the experience or job. How much anxiety? Dr. Todd Kashdan suggests that a balance between our novelty appreciation and our coping appreciation is required. He notes that two factors are at work to make us able to recoil from or embrace a truly new experience.

Our Novelty Potential is leveraged to find something new as challenging, unexpected, mysterious and an opportunity to learn and grow.

To it must be balanced our Coping Potential or our ability to judge whether or not we have the ability to make sense of the new.

If we can’t cope, we’re afraid and overanxious. Not coping is doesn’t make something actually harmful or dangerous. It is exposure to the truly new that develops potential for novelty and coping that supports the curious and exploratory live.

Coaches, like me, like to talk about potential, it keeps us (and our charges) busy. As you might guess, like anything else a coach develops, we’re going to say it takes practice.

Fortune favors the bold so get out there and get a little anxious. Feel the fluttering in your stomach and know it means your brain is on overdrive.

Technology is magical and fantastic — it takes us to places we’ll never go… allows us to reconnect with high school pals or say “I love you” via text, e-mail, instant message (or all three)… and lets us watch, again and again, the sweet moments of a child’s first piano recital… and, if you’re so inclined, to share them with the world on Facebook or YouTube.

However, technology also tends to take over our lives, says Daily Health News contributor and life coach Lauren Zander, noting that all these devices have complicated much about our lives — even the single, simple and supposedly mindless act of relaxing. Watching your favorite sitcom on TV has turned into an exercise of “hit the mute button during commercials and do e-mail or text on your laptop or phone,” points out Lauren. Technology blocks our ability to live the good life by gulping up available time that could, and often should, be spent on other more productive activities… and by putting up a barrier that gets in the way of relationships and experiences that could otherwise be more enriching. Lauren and I discussed how to turn this around so that we all stay in charge of our technology… and not the other way around.

Who Has “Free” Time?

Lauren points out that free time is precious, in that it offers a special opportunity to follow pursuits that make life richer, including personal exploration or development. But who has time for these pursuits? “Most people would be embarrassed to admit how many hours they waste on technology,” she said, calling it the “ultimate distraction” and a “thief of intimacy.” The result is that people often are too busy surfing the Web, returning e-mails and the like, to be truly present in their relationships. The thriving Internet porn industry provides an extreme example of how this is so. “The anonymous nature of Internet porn allows people to let their dark side run amok,” says Lauren. “It is a way for people to think they are happy in their virtual world and to numb themselves to the disappointments they experience in their real relationships.”

But even those whose online activities are aboveboard fall prey to the seductive qualities of online communication and social media. Texting and e-mailing can be easy, straightforward and incredibly efficient ways to communicate — but doing so habitually means you end up only skimming the surface of a relationship. There’s no nuance of gesture, eye contact, tone of voice or physical connection to tell you how someone really feels. You get only a piece of the interaction, and it’s often the least important part.

Technology also is seductive in how it makes us feel so important and desired. Responding to the buzz of your cell phone or that ding announcing that a text message has arrived is — momentarily, at least — far more gratifying then listening to your elderly mother complain about her sore hip. But, of course, your eager response to the distraction leaves mom feeling left behind and unimportant. Occasionally emergencies really do require your attention, but when such interruptions become a pattern in a relationship, problems are likely to arise.

Be Here Now

Technology also can rob you of the joy of full engagement. If you’re taking a video of your grandson’s first at-bat of the season, your experience of the moment is restricted to the viewfinder — forever. Yes, you capture the moment so that you can enjoy it again and again. But you’ll miss lots, too — like how your own son is puffed up with pride (or anxiety), not to mention actually witnessing the richness of your grandson’s performance and relishing your own good feelings about it. Wouldn’t it be better to hand the camera to someone else so that you can be fully present for what’s happening, creating your own memories that will make the experience all the richer?

Putting the Leash on Technology

Far too many people have fallen into the habit of constantly accepting the siren call of communication tools and technology. To keep that from happening — or to stop the habit if you are already addicted — requires setting rules, says Lauren. This will “put a leash on the problem so technology serves you without stealing all of your life.” She has several simple suggestions…

Assess exactly how much time you are devoting to technology and for what purposes. What is necessary, satisfying and life-enhancing… what is just killing time? What more rewarding activities could you be doing with that time instead? Lauren admits that she recently realized that she was no longer reading books — just e-mails, reports and other online content. “Reading feeds creativity and imagination and I’ve always loved it, but I hadn’t read a single book in two years! The problem wasn’t how busy my children keep me. It was that I had turned my free time over to my laptop — doing e-mails and surfing the Internet,” she says.

Be mindful of what’s really happening. Remember that your life is not a photo album or a movie — those are mementos, not the point. If you’re spending time with your family, turn off the technology and enjoy yourselves.

Set limits on how and when you use technology — and respect those limits. Lauren calls this an issue of integrity. Technology can become an addiction that makes it easy to avoid thinking about real challenges, such as a troubled relationship or an unhappy work situation. It provides a reason to avoid time with the person or problem that might resolve the issue. To restore balance, you might decide family meals are sacrosanct (no phone interruptions allowed)… or leave all laptops at home when you go on vacation… or take no text messages except when you are at work — what, when and how much is up to you and your family. What’s important, however, is that you stick to the limits you set… because you value your real life most of all.

Lauren reminds us that when it comes to technology, we need to remember who’s the boss. You don’t work for it — it works for you. Use your gadgets with this in mind, and they will indeed be useful and life-enhancing.

Increase your CQ (Connectability Quotient) with LinkedIn’s features and applications. After all, they’re designed to help you connect with others. So start connecting. Here’s how:

People you know

If you see that someone you’d like to connect with was a former colleague or belongs to an organization to which you belong, you can send an “Add to network” request. Make sure there is genuinely a real connection between you and the other person, or you run the risk of being reported for “spamming” (sending unwanted messages).

Friends of people you know

Reach out to the people your current connections know. Develop a list of people who you’d like to meet. As in the real world, the best way to get the attention of a busy person is to be introduced by someone they already know and trust. LinkedIn facilitates this via its Introductions tool. When you have found someone whom one of your existing connections knows, go to the new person’s profile and click “Get Introduced.”

LinkedIn will then present you with a form to complete that provides a space for you to write a note to the person to whom you want to be introduced and the person from whom you are requesting the introduction. Be sure to give the person from whom you are requesting the introduction a compelling reason to forward the request to his connection on your behalf – it will help him write a cover note that explains why the person should want to connect with you.

People you don’t know – yet

You can also reach out to people you’d like to connect with directly by using InMails. These notes allow you to contact people without an introduction. Be sure to check the types of connections that each person indicates an interest in on their profile (such as “Getting Back in Touch,” “Job Inquiries” and “Expertise Requests”). Unlike “Add to Network” requests, InMail is not free. You can sign up to use InMail by upgrading to a paid account. (Currently, pricing starts at $24.95 per month.)

Just having a strong network isn’t the end game – it’s just the beginning. Now you have a community to interact with. Make it easy for your connections to keep you top-of-mind as they come across opportunities that are right for you.

Start by taking these steps:

1. Join groups

You can also increase your CQ by joining LinkedIn Groups. Groups can be virtual extensions of associations to which you belong outside LinkedIn or groups that were created and exist solely on LinkedIn. Once in a group, you should not begin posting messages right away; instead, look at the conversations that are ongoing or were recently closed to get a sense of how the members communicate. As with all social media, overt self-promotion is bad form. Instead, think of what you can bring to others by sharing your expertise with the group. By establishing yourself as a knowledgeable resource, people will be more inclined to connect with you and recommend your expertise to others.

2. Post updates on your profile

To stay visible to your connections, post regular updates on your profile. If you have a Twitter account, you can set LinkedIn to import your tweets to your profile. The same can be done with your blog using the Blog Link or WordPress applications. Again, avoid blatant self-promotion, and instead share info about yourself that provides a benefit to others. Posting a link to an article you found interesting shows that you’re staying abreast of industry events and sharing the news with others who may find value in the news too.

3. Answer questions

Another way to raise your visibility on LinkedIn is to answer questions posted in the Answers section. Find topics of interest on which you can share your expertise and post responses to recent questions. The fact that you answered the question will be shared with your network as “news” about you.

4. Share your work

And don’t forget to check out applications that round out the information presented in your profile. SlideShare and Google Presentation enable you to upload presentations for easy sharing of your expertise and POV with others. Box.Net allows you to upload files and collaborate on them with your connections.

5. Attend events

The Events application lets you find events of interest and, when you sign up as a speaker or event attendee, the application tells your network about this activity. Each of these and other applications on LinkedIn increases your visibility and helps to position you as an expert based on what you choose to share.

As a means for connecting you to people who can help you and the job of your dreams, it’s hard to find a better platform for increasing your CQ than LinkedIn.

Veronica Fielding is president and founder of Digital Brand Expressions and its service line for using social media for career enhancement, Jump Start Social MediaSM. She is a recognized Internet marketing expert who is frequently asked to speak on topics relating to findability marketing (search engine optimization, paid search, and social media channels) as well as the evolution of new media technologies. To learn more about how Jump Start Social Media is helping today’s business professionals get the most out of LinkedIn®, TwitterTM and Facebook®, check out Jump Start’s online business networking solutions

Or maybe have football nightmares? Perhaps his last throw last night? What I’m wondering is if our dreams, like our behaviors, are shaped by our innate talents and conditioned values?
I make a living making peoples dreams come true. Actually, they make their dreams come true. I just coach. If it is obvious that what we can do is both limited and reinforced by our talents, values and behaviors, is the same true of our aspirations?
One of the things we do to help people achieve is a dream inventory. While certainly it is important to know these dreams as they seed the goals that bring success and happiness. I’ve found it equally important to know why these dreams and not others?
If our dreams are wildly divergent from our real life activity might there be a clue to feelings of dissatisfaction?
Do your dreams seem close to touch? Can you easily envision yourself living them? Or,are they misty visions of a world you can’t get your head around?
I’d like to hear your thoughts on this. I recently became certified in the delivery and interpretation of an award winning measure of talents, values and behaviors that has been effectively used by over a quarter million people and has been in use and scientifically validated time and again over a half century.
It will certainly be fun to find out more about how you think eh? And perchance to dream.

If you’re one of the 20% of Americans who suffer from irritable bowel syndrome (IBS), you’ve probably been told that consuming more fiber will alleviate your symptoms — but were you told what kind? A new study, published in British Medical Journal, finds that the soluble fiber found in psyllium supplements may be more effective than insoluble bran fiber for relieving the constipation, bloating and diarrhea that accompany IBS.

Researchers at University Medical Center in Utrecht randomly assigned participants to one of three groups. Each participant took 10 grams of psyllium, insoluble bran or a placebo (rice flour in this case) twice daily for 12 weeks. Researchers evaluated patients at one, two and three months to see how they fared in terms of relief of symptoms, severity of abdominal pain and overall quality of life.

Over the course of the trial, psyllium was significantly better than both bran and the placebo at reducing abdominal pain and other issues with IBS — and this was true whether a patient’s IBS was dominated by constipation or diarrhea or both. Even more surprising, though, was the fact that the bran did worst of all — in fact, the bran actually seemed to worsen patients’ symptoms.

Why Bran Bombed

This result was so unexpected that I checked in with our medical editor, Andrew L. Rubman, ND, to see whether he had any theories about why the bran group got such poor results. Dr. Rubman pointed out that the study was relatively small — 275 patients — and that by the end 40% of the participants had dropped out. He found it telling that, though participants initially did not know which group they belonged to (psyllium, bran or placebo), the research report noted that most of them were able to guess correctly which treatment they were getting.

Dr. Rubman believes these results are likely due to the fact that bran must be metabolized, and people with IBS lack the “good gut bacteria” necessary to properly break it down, which made life unpleasant for that particular study group. Dr. Rubman noted that bran is insoluble and has a rough texture that sometimes acts as an irritant on the stomach lining in those with chronic gastritis.

Psyllium, on the other hand, can soothe the stomach lining. Psyllium is soluble, meaning it disperses in water, and forms a gel which travels through the digestive system, coating and calming its lining, making for a very different journey.

So, if you have IBS and currently take bran, you may want to ask your doctor whether it’s advisable to switch to psyllium. If you decide to give it a try, keep in mind that plain psyllium seed husks are best. There’s no need to buy expensive products touting exotic sources, special compounding benefits or exclusive additives that supposedly improve the material. Also avoid commercial psyllium brands sweetened with loads of sugar. Dr. Rubman suggests buying psyllium in bulk at health food stores, where the best stuff also happens to be the least expensive.

Welcome aboard! It’s time to pry my coaching and development blogbits out of www.adampressman.com and start a dedicated blog to the passion of personal development. Polishing people and their processes to be as bright and valuable as possible is the theme of what you’ll find here. I look forward to hearing from you learning and teaching in the area of personal development, leadership and coaching.

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The Formula for Success

This is the cocktail napkin presentation I'm likely to do and expand when we meet. I hope you'll find as I have, that success has a repeatable, easy to understand formula.
When followed you will live a life of constant attainment of your predetermined goals.